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Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the...
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Transcript of Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the...
![Page 1: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/1.jpg)
Slackers Radiation Oncology Fact Stack
Mike Ori
![Page 2: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/2.jpg)
Disclaimer
• These represent my understanding of the subject and have not been vetted or reviewed by faculty. Use at your own peril.
• I can’t type so below are common missing letters you may need to supply
• e r l• I didn’t use greek letters because they are a
pain to cut and paste in.
![Page 3: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/3.jpg)
• What are the five stages of cancer diagnosis and therapy
![Page 4: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/4.jpg)
• Screening• Diagnosis• Staging• Therapy• Follow-up
![Page 5: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/5.jpg)
• What is the most successful use of radiology for screening
![Page 6: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/6.jpg)
• Mammography
![Page 7: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/7.jpg)
• What is one area where radiology techniques have not been successful in screening
![Page 8: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/8.jpg)
• Ultrasound screening of the prostate
![Page 9: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/9.jpg)
• Explain the role of contrast kinetics in MRI
![Page 10: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/10.jpg)
• Wash-in and wash-out times help differentiate benign and malignant
• Normal tissue tends to have slower wash-in and wash-out kinetics than tumor.
![Page 11: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/11.jpg)
• What is a sestamibi scan
![Page 12: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/12.jpg)
• Use of 99mTc-sestamibi to identify areas of angiogenesis and tumor.
![Page 13: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/13.jpg)
• Compare sestamibi scans to MRI
![Page 14: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/14.jpg)
• Uses ionizing radiation• Not as available as MR• Faster• Cheaper
![Page 15: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/15.jpg)
• What is octreotide scanning
![Page 16: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/16.jpg)
• A somatostatin-like compound that can interact wit somatostatin receptors on the surface of cells. Some types of cancer (neuro-endocrine mostly) are notable for such receptors.
![Page 17: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/17.jpg)
• Compare octreotide scanning to MRI/CT
![Page 18: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/18.jpg)
• Sometimes shows mets when other modalities don’t
• Poorer anatomic localization than other modalities
• Can be used to indicate treatment with yttrium 90-octrotide
![Page 19: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/19.jpg)
• What is MRI spectroscopy
![Page 20: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/20.jpg)
• The use of the MRI machine to perform spectroscopic analysis of tissue to look for marker compounds that indicate growth or abnormal metabolism.
• Rarely used capability due to reimbursement
![Page 21: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/21.jpg)
• What radiographic techniques can be used to stage cancer
![Page 22: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/22.jpg)
• CT– The workhorse
• PET– Especially when combine with CT
• MRI– Increasing in use. Dominant in some areas
• Radionucleotide bone scans– For skeletal mets
• Ultrasound– Rarely
![Page 23: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/23.jpg)
• How does PET scanning work
![Page 24: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/24.jpg)
• Fluoro-D-Glucose is injected into the body. Hot spots appear in any tissue actively metabolizing glucose. This includes tumors but also inflammed and regnerating areas.
![Page 25: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/25.jpg)
• For what cancers is PET scanning approved
![Page 26: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/26.jpg)
• Non-small cell lung cancer• Colorectal cancer• Melanoma• Lymphoma• Head and neck cancer (not thyroid or CNS)• Esophageal• Cervical• Breast monitoring and restaging• Thyroid restaging
![Page 27: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/27.jpg)
• Explain radionucleotide bone scans
![Page 28: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/28.jpg)
• 99mTC-methylene diphosphonate is injected into the body and incorporated into hydroxyapatite in the bone by osteoblasts. Thus areas of bone growth are visible.
• Needs follow-up anatomic imaging
![Page 29: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/29.jpg)
• What is the role of radioactive iodine in the treatment of thyroid neoplasia
![Page 30: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/30.jpg)
• RAI is used post surgery to destroy remaining thyroid tissue.
![Page 31: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/31.jpg)
• What is image guided therapy
![Page 32: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/32.jpg)
• The use of radiology techniques in the performance of treatment
• Intra arterial chemo catheter• Embolization– Simple– Chemo
• Alcohol ablation/cryotherapy• RF ablation• Focused ultrasound
![Page 33: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/33.jpg)
• What is RECIST
![Page 34: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/34.jpg)
• Response evaluation criteria in solid tumors is an heuristic used to quantify the change in a solid tumor over time.– CR = complete response– PR = partial response, 30% decrease– PD = progressive disease, 20% increase– SD = stable disease
![Page 35: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/35.jpg)
• What type of radiation is used in radiotherapy
![Page 36: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/36.jpg)
• Ionizing radiation such as x-rays, gamma rays, electrons, protons
![Page 37: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/37.jpg)
• What device produces the radiation used most predominantly in the US
![Page 38: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/38.jpg)
• The linear accelerator or linac
![Page 39: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/39.jpg)
• How many linacs can fit on the head of a pin?
![Page 40: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/40.jpg)
• None.
![Page 41: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/41.jpg)
• Differentiate teletherapy from brachytherapy
![Page 42: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/42.jpg)
• Teletherapy uses a radiation beam generated by source remote to the patient. This is your classic sci-fi death ray.
• Brachytherapy places an intrinsically radioactive substance in close approximation to the target tissue.
![Page 43: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/43.jpg)
• What is linear energy transfer
![Page 44: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/44.jpg)
• The amount of energy transferred per unit length of track
![Page 45: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/45.jpg)
• What is the bragg peak
![Page 46: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/46.jpg)
• The point of maximum energy release along a track.
![Page 47: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/47.jpg)
• Differentiate directly ionizing from indirectly ionizing radiation
![Page 48: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/48.jpg)
• Directly ionizing radiation has sufficient energy to directly disrupt the atomic structure of DNA. Protons.
• Indirectly ionizing radiation creates free radicals that damage DNA. X-rays.
![Page 49: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/49.jpg)
• What is the primary method of cell killing caused by radiation
![Page 50: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/50.jpg)
• Double stand DNA breaks that are improperly repaired.
![Page 51: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/51.jpg)
• Why are oxygenated cells more susceptible to radiation than are hypoxic cells
![Page 52: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/52.jpg)
• The ionizing process generates free electrons which are taken up by oxygen to generate oxygen radicals which attack DNA. In hypoxic conditions, less oxygen is available to generate free radicals.
![Page 53: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/53.jpg)
• Which phase of the cell cycle is sensitive to radiation? Which is resistant?
![Page 54: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/54.jpg)
• G1/M are sensitive• S is resistant
![Page 55: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/55.jpg)
• What factors influence the survival of a radiated cell?
![Page 56: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/56.jpg)
• Position in the mitotic cycle• Molecular checkpoint activation• Hypoxia• Repopulation
![Page 57: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/57.jpg)
• Describe how a 50Gy dose of radiation is delivered to patients
![Page 58: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/58.jpg)
• The dose is usually fractionated into multiple doses of ~2Gy. These are then delivered over the course of many days until the total prescription is delivered.
![Page 59: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/59.jpg)
• Describe image modulated radiation therapy
![Page 60: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/60.jpg)
• IMRT uses a multi-leaf collimator shape a radiation beam to limit exposure of adjacent structures.
![Page 61: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/61.jpg)
• List several benign diseases for which radiotherapy can be prescribed
![Page 62: Slackers Radiation Oncology Fact Stack Mike Ori. Disclaimer These represent my understanding of the subject and have not been vetted or reviewed by faculty.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649d2e5503460f94a04c8f/html5/thumbnails/62.jpg)
• Omas of the CNS– Schwanoma– Chordoma– Meningioma– Pituitary adenoma
• AVM• Trigeminal neuralgia• Pterygium• Heterotopic ossification• Trigeminal neuralgia